think Lapatinib is failing

[lindaw]

Hi

Seems Lapatinib/xeloda has run its course for me - little skin mets are reappearing on my arm.Showed Onc last week and he said we will watch it closely. Still skin mets only CT scan clear - but the open mets on my chest have been there for a bout a year and a half and I have been dressing them all that time.

Not many chemos left. It seems -

had taxol, navelbine, xeloda, caelyx(doxil) carboplatin,gemzar and now lapatinib.

I guess it will be taxotere - like I said before I will have to try it without steroids as last time it gave me osteonecrosis in my bomnesd which we caught early - luckily as it could have meant a hip / knee replacement.

Feels kind of surreal and to be expected - I always only get about 3-4 months on a chemo - except for first time xeloda.Am waiting for lapatinib to make the Therapeutic Goods thingy here and then mix with herceptin as like I said before - got great response first month and am convinced its due to crossover with herceptin.

Guess i will have to look for a wig again.

love
linda

[janet/FL]

Linda
I will be interested in your experience of Taxotere w/o a steriod. I think others on this list have done it. I would have liked to have turned it down. If you want to try to protect your fingernails use bags of frozen peas during infusion. Thats about the only advice I could give you.
Crossing my fingers that all goes well and that you find that right combination to get you NED--
Janet/FL

[Sandy H]

So sorry to hear this. Its never an ending journey here. Have you considered avastin or is it not in your country? There are trials doing Avastin/Tykerb I believe if not correct than someone please correct me. hugs, Sandy

[Becky]

Another option is weekly abraxane with Avastin and Herceptin or weekly Abraxane with Herceptin. 2006 San Antonio BC symposium presented a paper that weekly Abraxane is superior to Taxotere or Taxol given in the traditional method (every 3 weeks). This with Herceptin and/or Avastin showed great promise even in heavily pretreated women.


You are just going to have to work alittle harder and you've worked hard already. In articles of interest Heblaj01 posted an article about a phase I study with oral Navelbine and Xeloda.

You could also soon have your onc try Tykerb with a taxane (and maybe he will throw in some Herceptin or Avastin). You still have lots of combos to try out and we are here with you and praying for you.

Love and hugs

PS I forgot to add that you don't need benadryl or steriods to use Abraxane but it is a taxane.

[lindaw]

Hi All
thanks for quick response and support.
Avastin and abraxene not approved here and the tykerb cannot be mixed with anything else but xeloda in the trial.

I will give it the week and if more progression I will go back and see.

Navelbine didn't work for me - not sure if mix with xeloda will.

Any more ideas.

love
linda

[heblaj01]

Linda,
In addition to all the above suggestions of treatments, you may ask your onc what he thinks of Doxil+Herceptin which had high response rate in phase 2 clinical trials in 2006.It is not yet approved as a combo but he probably is allowed to prescribe it off label since each drug is already approved.
Regarding skin mets, I wonder if ointments containing green tea extract EGCG might help as topical treatment.

[lindaw]

I have had doxil and herceptim


Where do you get the green tea stuff from?

love
linda

[heblaj01]

Linda,
The only approved ointment containing EGCG I am aware of is Polyphenon E.
The approval by FDA was for warts (see article below) not cancer but preclinical studies of EGCG have shown skin protective activity against cancer causing sunlight & some chemicals.
So you certainly will need the OK & a prescription from your caregiver to use this product or any similar ointment which a compounding pharmacist could prepare.

http://www.herbalgram.org/default.asp?c=gthpv
FDA Approves Special Green Tea Extract as a New Topical Drug for Genital Warts

P.S.
Lani has posted an article about Sutent a drug in clinical trial in 2006 which may be approved this year:
http://abclocal.go.com/kgo/story?section=edell&id=4808127

Regarding Doxil & Herceptin: did you take them concurrently or successively?
If you took them successively: ask your onc if the combo is still indicated.

[heblaj01]

Linda,
I forgot an other option although you still have not exhausted several standard regimens. I am refering to frequent low dose chemo (in particular using Cytoxan) which has been shown to be active even after becoming resistant to the higher standard doses of the same drugs.

[lindaw]

Dear Heblaj


Thank you so much to you and the others who replied. You are all trying so hard to help me . I feel very grateful to be on the list. Skin mets are not major but the impact on life is - its visual, distressing, ongoing for me with wound care and dressing in hot weather when you want circulation and air is restricted as I have bandages on my collar and chest.

Thanks for helping - I will see if the skin changes this week with the reintroduction of xeloda and if it conitnues to grow will get a early appointment. also have a dermatology appointment Thursday - hoping for improved wound care.

love
linda

[lindaw]

Sandy


I am very interested in this trial but I guess it will only be in USA.Offers a glimmer of hope though.You will be able to do it. Thats great.

love Linda